Atlantoaxial Rotatory Dislocation

Niibayashi, Hiroshi

doi:10.1097/00007632-199807010-00012

Cited by 25 publications

(9 citation statements)

References 10 publications

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“…These ligaments enable a rotation of 65° around the odontoid apex [4,11,12]. In complete or contralateral atlantoaxial dislocation, an anterior shift of >5 mm or rotation of >45° in association with obliteration of the spinal canal of ·12 mm is observed [7,13].…”

Section: Discussionmentioning

confidence: 99%

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Atlantoaxial rotational dislocation and associated multiple-level fractures to the spine

Karampinas

Nikolopoulos

Kavroudakis

et al. 2011

Eur J Orthop Surg Traumatol

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We present a case of a young woman with multilevel spinal injuries. The injury includes a rotational atlantoaxial dislocation associated with concomitant injury at C5 and at the sacrum. Rotational dislocation at C1-C2 level is not frequently encountered in young adults, and the presence of associated lesions to the spine makes this condition a challenging one. The medical record of a patient who sustained three spinal injuries at diVerent levels of the spine was evaluated. The prevalence of this type of injury, the diagnosis, the clinical behavior, and the applied treatment are evaluated. The patient was treated non-operatively, and a satisfactory clinical outcome was recorded at the last follow-up visit.

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Section: Discussionmentioning

confidence: 99%

“…The early diagnosis and treatment of the injury with head traction for 48 h will conclude to the reduction in the dislocation fast, easily and without any risk of recurrence [7,11]. Then, the patient's cervical spine should be immobilized with a cervical collar or a Halo vest for a 6-10 week-period [21].…”

Section: Discussionmentioning

confidence: 99%

Atlantoaxial rotational dislocation and associated multiple-level fractures to the spine

Karampinas

Nikolopoulos

Kavroudakis

et al. 2011

Eur J Orthop Surg Traumatol

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“…The alar ligaments pass from the lateral occipital processes to the posterolateral margin of the odontoid apex and are thought to prevent anterior shift of the atlas on the axis and also to prevent excessive rotation at the atlantoaxial joint (5,26,35). A case report involving a pediatric patient and magnetic resonance imaging suggests that alar ligament disruption could be a mechanism by which rotatory subluxation occurs (26). However, only 4 of 14 adult specimens in our study showed signs of damage to the right alar ligament after left hyperrotation.…”

Section: Discussionmentioning

confidence: 99%

Atlantoaxial Rotatory Subluxation With Ligamentous Disruption

Rocha

Sawa

Baek

et al. 2009

Operative Neurosurgery

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“…Magnetic resonance imaging studies suggest that alar ligament disruption is the mechanism responsible for rotatory subluxation. 13,22 Two classification systems for atlantoaxial rotatory subluxation have been described by Fielding and Hawkins 5 and White and Panjabi. 21 These systems are based on radiological findings by assessing the direction of atlantal displacement and the pivotal axis ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

Conservative management of a traumatic unilateral rotatory atlantoaxial subluxation in an adult: Case report and review

Haliasos

Norris

2007

Injury Extra

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A 19-year old 11 weeks pregnant woman was admitted to Hurstwood Park Neurosciences Centre following a road traffic crash. The patient was a front seat passenger wearing a seat belt when the car was hit on the side by an oncoming vehicle at 30 mph (airbags deployed). She was able to walk out of the car but noticed immediate neck pain, stiffness and torticollis. The patient had a history of mild cerebral palsy with a degree of learning difficulty and a mild weakness of the right side of her body since birth (full term pregnancy, normal delivery). No further neurological deficits were noted after the crash. On admission, plain X-rays revealed odontoid lateral mass asymmetry and a CTof the spine with 3D reconstruction revealed a unilateral atlantoaxial rotatory subluxation with a small chip fracture of the lateral mass of C1 that was not deemed significant (Fig. 1). The patient was placed in skull traction for the next 15 days starting at 5 lb up to 15 lb (patient's weight 98 lb). During the traction her cervical spine became more comfortable and the torticollis resolved. However, further 3D CT (Fig. 2) showed that the subluxation had not reduced. After 15 days the traction was removed and the patient was very comfortable with no neck tenderness, no torticollis and full range of movements. After a multidisciplinary discussion the patient was discharged home with a Miami-J collar to allow further safe recovery. The patient was followed up after 1 month and she remained well. Flexion/extension Xrays (Fig. 3) were entirely satisfactory so the collar was removed. During the second follow up 2 months after the injury the patient had no complaints and the new flexion/extension views showed no change. Further follow up is planned in a year's time before discharge from the outpatients clinic. DiscussionTraumatic subluxation of the C1 (atlas) is defined as C1 instability relative to the axis of C2 due to disruption or insufficiency of the ligamentous complex of the atlantoaxial joint and is a rare occurrence in adults.

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Atlantoaxial Rotatory Dislocation

Abstract: Concomitant fractures of the right temporal bone and the right clavicle may yield excessive left rotation of the atlas on the axis, resulting in the rupture of the right alar ligament. Awareness of this condition allows early diagnosis and effective conservative treatment.

Cited by 25 publications

References 10 publications

Atlantoaxial rotational dislocation and associated multiple-level fractures to the spine

Atlantoaxial rotational dislocation and associated multiple-level fractures to the spine

Atlantoaxial Rotatory Subluxation With Ligamentous Disruption

Conservative management of a traumatic unilateral rotatory atlantoaxial subluxation in an adult: Case report and review

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